In hospital with partial bowel obstruction

Hi gang,

I ate Chinese food last night and I ate some veggies that may not have been cooked as much as I usually eat. (Big crime, I know) Anyway, I had the terrible spasm contracting pain all day and I finally gave in and went to the ER and was admitted with a partial bowel obstruction. My GI called in orders but did not see me. He ordered pain meds and IV's but no steroids. Here is what the CT scan said:

FINDINGS:

The liver, gallbladder, biliary tree, spleen, adrenals, pancreas, kidneys and aorta demonstrate no pathology. The stomach is distended. There are some dilated small bowel loops particularly in the pelvis. There is diffuse thickening of the wall of the distal and terminal ileum consistent with the clinical diagnosis of Crohn's disease. This appears to be producing a degree of small bowel obstruction. No perforation or abscess is seen. There is some free fluid in the pelvic cul-de-sac. No inguinal adenopathy is identified.

Bone windows demonstrate no fracture or destruction.

IMPRESSION:

1. No acute pathology in the abdomen.

2. Findings consistent with partial small bowel obstruction with circumferential wall thickening of a fairly long segment of the distal and terminal ileum consistent with the clinical diagnosis of Crohn's disease.

3. No evidence of perforation or abscess.

4. There is some minimal free ascites noted in the pelvic cul-de-sac.

I will see my GI in the morning, but I was just wondering what you guys think. My doc has a tendency to under treat. Should I be insisting to be put on steroids? I am only on Pentasa.

I'm so busy with work...the timing of this sucks. I REALLY hate this disease. The dilaudid is helping a lot, so at least I have that. Thanks for any input

Gumby,

So sorry to hear you're in the hospital. Having been through the partial obstruction experience a few times, I'm almost sure they'll start you on steroids when you are seen.

Hang in there - try to rest and not think about the "big picture" too much..just take each day as it comes.

Sending a ((hug)).

Sorry that you are suffering. Wishing you a speedy recovery. Hopefully, they'll start you off on steroids and you'll feel better soon.
{{{Hugs}}}

And here you were worried about me.  I am so sorry you are hurting.  I guess my question to you is the same you had for me....get him to determine scarring/stricturing versus inflammation.  If it's inflammation...see what happens with the pred.  If you think you have suffered enough (and you have had a long time now it seems where things weren't quite right), it may be time to up the ante on the meds.  I would say that you have to decide if it is affecting your daily life enough.

If it's scarring/stricturing, I would ask about balloon expansion and other options.

I hope the pain meds are helping and that you get to an answer soon. Take care and keep us up to date!

Glad you're starting to feel a bit better gumby! I think you're exactly right to just take it one step at a time, see how the steroids help (assuming this is just inflammation), and try not to worry about next steps. Easier said than done, but I know for me, stressing out only makes things worse.

Gumby44, I'm sorry that you're suffering. I remember that you had replied to many of my posts. You had mentioned that you had been in remission by taking the pills promptly and one of the few cases that handled CD well. It's really disgusting that we maintain our health well and all of a sudden we eat something by mistake and fall sick. Please do let us know the further findings. I wish you a speedy recovery.

My hubby, (who is usually extremely wonderful) came in to the hospital fairly loud and angry about me even considering biologics as he is terrified of cancer and thinks it was just "the vegetables" that I ate. I do talk to him a lot, but I'm the one who does all the reading, etc. I was too tired and sick to deal with him and they gave me phenargan which was putting me to sleep so I sent him home for awhile. I know he's tired, scared and stressed, but it was one of those moments when I wished I had all of you here. I had to apologize to my very sweet nurse because he was acting like a demanding bulldog. He sounded better on the phone....I think being the loved one is sometimes harder than being a patient...sheesh!

I hope you're feeling better and the obstruction is letting up. I thought I was the only one with a family member who is scared to death of the biologics. My daughter is that way too. Hugs! -Joy

Thanks everyone....I'm getting impatient...still no movement.I guess I'll be here another day

*hugs* to gumby. Not been online for a while, so only saw this just now.

Yeah, it's time to consider the biologics. For whatever it's worth, they are relatively safe drugs: the cancer risk is so overblown out of proportion, it's unreal. My beef with the biologics is not that they cause cancer - they don't, it really is that simple - but they can have other debilitating side-effects. It's not inevitable and many people take a biological med without any side-effects at all. But still: you're suppressing a part of your immune system and that can be rough on the body.

Not sure what else to say, other than I hope you get out of hospital ASAP. This is where my pessimism and frustration at the lack of decent treatments for Crohn's gets to me (and a large part of why I do not post much on this board anymore). I do think your disease has been undertreated, but I can't entirely blame your doctor: there just is nothing to treat Crohn's at the 'milder' end of the spectrum, apart from mesalamines which are useless for Crohn's.

You could consider low dose (the low dose part is crucial) 6MP or Imuran in combination with Allopurinol, which reduces the hepatological (liver-related) side-effects. Or methotrexate. Otherwise... yeah, you got it, take your pick between Remicade and Humira :-/

*post hijack*
NCOT, you're BACK!!!!! :) Yay!!!
*return to regular thread*

@gumby, hope you get out of the hospital soon. :( Ugh, I hate NG tubes. Praying that stuff starts moving soon! It could be because of the pain meds. I know that always slows me down.

Sorry your in pain,hope it's over soon so you can get back to your life!i will say a prayer for you

thiis-or-that thanks for ur support!!